title: Pilot study of locomotion improvement using hybrid assistive limb in chronic stroke patients.
abstract: BACKGROUND
  Locomotor training using robots is increasingly being used for rehabilitation to reduce manpower and the heavy burden on therapists, and the effectiveness of such techniques has been investigated. The robot suit Hybrid Assistive Limb (HAL) has been developed to rehabilitate or support motor function in people with disabilities. The HAL provides motion support that is tailored to the wearer's voluntary drive. We performed a pilot clinical trial to investigate the feasibility of locomotor training using the HAL in chronic stroke patients, and to examine differences between two functional ambulation subgroups.
  
  
  METHODS
  Sixteen stroke patients in the chronic stage participated in this study. All patients were trained with the HAL over 16 sessions (20-30 min/day within 2 days/week). Primary outcomes were walking speed, cadence, and number of steps recorded during a 10-meter walk test (10MWT). Berg balance scale (BBS) and timed up and go (TUG) were also measured. All outcome measures were evaluated without wearing HAL assistance before and after the intervention in all patients as well as in the dependent ambulatory and independent ambulatory subgroups.
  
  
  RESULTS
  All participants completed the intervention with no adverse events. Gait speed, cadence, number of steps during the 10MWT, and BBS increased significantly from 0.41 m/s to 0.45 m/s (P = 0.031), from 68.6 steps/min to 72.0 steps/min (P = 0.020), from 37.5 steps to 33.1 steps (P = 0.017), and from 40.6 to 45.4 (P = 0.004) respectively. The TUG test score improved, although this difference was not statistically significant. The findings in the dependent ambulatory subgroup primarily contributed to the significant differences observed in the group as a whole.
  
  
  CONCLUSIONS
  This pilot study showed that locomotor training using the HAL is feasible for chronic stroke patients. Randomized controlled trials are now required to demonstrate the effectiveness of HAL-based rehabilitation over conventional therapies.
  
  
  BACKGROUND
  UMIN000002969.
authors.affiliation: Faculty of Medicine, University of Tsukuba, Ibaraki, Japan. kyeguchi@md.tsukuba.ac.jp.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kawamoto
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Kamibayashi
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Nakata
authors.forename: Kanako
authors.initials: K
authors.lastname: Yamawaki
authors.forename: Ryohei
authors.initials: R
authors.lastname: Ariyasu
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Sankai
authors.forename: Masataka
authors.initials: M
authors.lastname: Sakane
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Eguchi
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Ochiai
mesh_terms: D000368:Aged; D002908:Chronic Disease; D005081:Exercise Therapy / Q000379:methods*; D005121:Extremities / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008124:Locomotion / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010865:Pilot Projects; D018709:Statistics, Nonparametric; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation